The Health Insurance Service Providers Association of Ghana (HISPAG) has served notice it will suspend services to patients across the country if the National Health Insurance Authority (NHIA) fails to pay their outstanding claims.
HISPAG says all payments to its members have been suspended pending the conclusion of a probe by the Bureau of National Investigations (BNI) into NHIA activities.
The BNI has been investigating cases of alleged fraudulent payments to some health institutions by the NHIA and recently froze the accounts of the former Chief Executive Officer (CEO), Sylvester Mensah.
Executive Director of HISPAG, Frank Torblu, says the decision to suspend paymentS to service providers is unjustified.
He said the NHIA owes the service providers over GH¢600 million in seven months’ arrears.
“They are saying that they are not going to pay the providers until they have completed their investigations and we are saying that should the hospitals, clinics and maternity homes across the country also suspend provision of services to the generality of the people until that investigation is complete?” Mr Frank Torblu quizzed.
Responding to the claims by Mr. Torblu, Deputy Director, Communications, NHIA, Selorm Adonoo, said the NHIA was preparing to make claims payments before the close of this week.
“There has been quite some delay in claims reimbursement to our service provider partners but we will be making some payments this week. In terms of the NHIA’s indebtedness to our service providers, as long as the Scheme remains a post-paid one, we will continue to pay in arrears.
“This is because the Scheme by design, makes payment after service has been delivered, so there is no problem with that. I think the issue our service provider partners have had is with the delays which occur along the line,” he said.
Mr Adonoo said although service providers will be happy if the NHIA is able to pay within the agreed three months’ period after claims submission, “We are working hard to reduce the claims turnaround time so that service providers can be happier than they are now.”
He also indicated that the NHIA had not stated anywhere that it is unable to pay claims because of the ongoing probe by the BNI.
“I think by close of this week when some payments are made, all these speculations will be muted.
“It must however, be pointed out that only NHIS service providers in good standing will be paid. By good standing, I mean service providers who have active and valid credentials or accreditation status with the NHIA or those whose applications for credential renewal have already been submitted to the Authority. Those with expired credentials will not be paid,” he added.
By Jamila Akweley Okertchiri